Introduction: Men who have sex with men (MSM) are a vulnerable subgroup for problems with substance use, including crystal methamphetamine. Drug use in sexual settings, commonly referred to as “chemsex,” has been an issue of growing concern in MSM communities. Recreational drugs commonly associated with chemsex include crystal methamphetamine, gamma-hydroxybutyrate/gamma-butyrolactone (GHB/GBL), mephedrone, and ketamine. Drug use in sexual settings is correlated with sexual practices associated with the acquisition and transmission of sexually transmitted infections, including HIV and hepatitis C. Adverse mental health outcomes are often reported at higher rates among MSM who use methamphetamine. Methods: This paper refers to a subset of participants from the German Chemsex Survey, an MSM-community recruited, self-completed online survey with a self-selected convenience sample. Participants who used crystal methamphetamine for sex (n = 130) were compared to participants who did not use drugs for sex (n = 177). The survey comprised 420 different items considering recreational substance use, substance use in sexual settings, harm reduction strategies, mental health, sexual transmitted infections, and mental health care service utilization. Results: A total of 1,583 men started the survey; 1,050 participants provided information on substance use. Twenty-seven percent of participants used crystal methamphetamine in the last 12 months, and of those, 89% used methamphetamine in a sexual setting and 50% reported injecting methamphetamine. Regarding mental health, participants who reported methamphetamine use in sexual settings were more likely to report symptoms of depression, somatization, anxiety, and posttraumatic stress disorder (PTSD) than the German male general population. Participants who reported methamphetamine use for sex were more likely to report symptoms of major depression, being HIV positive, and taking HIV pre-exposure prophylaxis (PrEP) than participants who did not report methamphetamine use. Most participants used harm reduction practices to reduce the risks associated with using methamphetamine in sexual settings. Conclusion: Crystal methamphetamine is used in the context of sexual activities by German MSM. Poorer mental health status than in the male general population was observed. MSM who used methamphetamine in this study seemed to be aware of potential health risks associated with their substance use and utilized harm reduction strategies and biomedical HIV prevention strategies like PrEP.

Unlike men, who are disproportionately affected by severe disease progression and mortality from COVID-19, women may be more affected by the economic, social and psychological consequences of the pandemic. Psychological distress and mental health problems are general risk factors for increases in the use of alcohol and other substances as a dysfunctional coping mechanism. Methods: An analysis was carried out of the female subset (n = 2153) of a population-based, cross-sectional online survey (October–December 2020), covering the “second wave” of the COVID-19 pandemic in Germany. Results: Among women, 23% increased their alcohol use, 28.4% increased their nicotine use and 44% increased their illicit substance use during the COVID-19 pandemic. Twenty percent reported major depressive symptoms and 23.4% symptoms of generalized anxiety. Generalized anxiety proved to be a significant predictor of increases in alcohol and nicotine use in logistic regression. Discussion: The mental health burden remained high during the second wave of COVID-19 and alcohol, nicotine and other substance use increased. However, the association between mental health and substance use was weak. Psychological distress does not seem to be the main motivator of substance use.

The impact of COVID-induced stress on mental health and alcohol use has been demonstrated in recent research. However, there is a lack of longitudinal data since most studies reported on cross-sectional data. It remains unclear how alcohol use develops under the dynamic changes of the pandemic. Therefore, the present study aims to investigate the general development of alcohol use and the impact of COVID related stress on drinking behavior in a German population-based sample during the pandemic in 2020. In the longitudinal design with three measurements (baseline [T1] and two follow-ups [T2, T3]) an online survey was administered. The survey included the Alcohol Use Disorder Identification Test (AUDIT) as well as the assessment of the drinking days in the last 30 days, the number of alcoholic beverages on each occasion and changes in alcohol use in the previous fourteen days. Further, COVID-19 related concerns, perceived stress, worries about friends and family and worries about the financial situation were also assessed and multiple linear regressions and confidence intervals (CI) were calculated. 1050 participants started the survey, 756 participants (71.4%), 317 (52.7%) participants completed the survey at all three measurements. Seventy six percent (n = 241) of the sample were female. An increase in alcohol use in the previous 14 days was reported by 10.9% at T1, 3.9% at T2 and 3.6% at T3. Moreover, a decrease in alcohol use in the previous 14 days was reported by 8.7% at T1, 6.5% at T2 and 4.1% at T3. The number of drinking days was significantly higher at T2 than at baseline (p < .001; F = − 2.06, [CI − 3.10, − 1.02]). COVID-19 related concerns and stress were associated with a higher number of drinking days and average number of drinks at a typical occasion. AUDIT score at baseline positively predicted number of drinking days as well as average number of drinks. The significant increases in alcohol use is a public health issue during COVID-19 pandemic. The findings show that especially people who drink more hazardously previously tend to drink more under pandemic conditions. Those individuals are particularly at risk for developing substance-related problems.

The responsiveness of professionals working with children and families is of key importance for child maltreatment early identification. However, this might be undermined when multifaceted circumstances, such as the COVID-19 pandemic, reduce interdisciplinary educational activities. Thanks to technological developments, digital platforms seem promising in dealing with new challenges for professionals’ training. We examined a digital approach to child maltreatment training through the ERICA project experience (Stopping Child Maltreatment through Pan-European Multiprofessional Training Programme). ERICA has been piloted during the pandemic in seven European centers involving interconnected sectors of professionals working with children and families. The training consisted of interactive modules embedded in a digital learning framework. Different aspects (technology, interaction, and organization) were evaluated and trainers’ feedback on digital features was sought. Technical issues were the main barrier, however, these did not significantly disrupt the training. The trainers perceived reduced interaction between participants, although distinct factors were uncovered as potential favorable mediators. Based on participants’ subjective experiences and perspectives, digital learning frameworks for professionals working with children and families (such as the ERICA model nested in its indispensable adaptation to an e-learning mode) can represent a novel interactive approach to empower trainers and trainees to tackle child maltreatment during critical times such as a pandemic, and as an alternative to more traditional learning frameworks.

Child maltreatment (CM) has been enormously studied. However, a preventive practice still requires comprehensive and effective instruments to assess the risks for CM in a family context. The aim of this study is to describe the development process of an evidence-based CM risk assessment instrument (Family Needs Checklist, FNC) for primary prevention online utilization. This article reports the development process of the checklist and its mobile application, consisting of a systematic literature review, identification of known risk factors using the content analysis method, and generation of the checklist, including a multidisciplinary group in the design and feedback. As a result, a comprehensive and compact checklist was developed to be used by parents or caregivers as a self-referral instrument with an option to be used with professionals as a basis for joint conversations. The FNC consists of parental, family-, and child-related risk factors. Based on the international evidence, the online application consists of knowledge about different CM types, information about risk factors and protective factors as well as recommendations and guidance to support services. The FNC is based on robust evidence on known risk factors causing CM in families. It can be used for primary prevention utilization in the general population.

Sex under the influence of psychoactive substances (SUIPS) has gained much attention in the press and scientific literature over the last years, especially among men who have sex with men (MSM). Concerns have thus far been expressed in relation to short-term physical health risks, like contracting bloodborne diseases, like viruses. However, much less is known about long-term mental health consequences of SUIPS, like depression, anxiety, and substance use disorders (SUD). Therefore, we systematically reviewed literature for evidence on mental health complications of SUIPS in MSM. SUIPS was associated with a lower general mental health status, and higher rates of depression, anxiety disorders and suicide ideation in 15 studies, and higher rates of SUD were found among MSM practicing SUIPS in four studies. Motives of SUIPS were increasing sexual performance, fear of rejection, anxiety, and low self-esteem among others. Furthermore, long-term mental health risks, as associated with some of the most frequently reported psychoactive substances in the context of SUIPS, include psychosis and substance dependence. Therefore, the present findings indicate that SUIPS is associated with mental disorders and that they are probably closely intertwined with motives for SUIPS and the long-term effects of using psychoactive substances. This underlines the need to address the presence of mental disorders in people practicing SUIPS, alongside the physical risks.